CONSULTATION IN PALLIATIVE MEDICINE

Palliative medicine is an emerging medical discipline in the United St ates, modeled after similar efforts in Great Britain, Australia, and C anada. Increasingly, academic medical centers are starting clinical pr ograms in palliative medicine including inpatient consultation service s. A description of the essential components of a palliative medicine consultation is presented, based on the author's experience of more th an 600 patient encounters at the Medical College of Wisconsin in Milwa ukee. A palliative medicine consultation consists oi 6 features: asses sment and management of physical symptoms; assisting patients to ident ify personal goals for end-of-life care; assessment and management oi psychological and spiritual needs; assessment of the patient's support system: assessment and communication of estimated prognosis; and asse ssment of discharge planning issues.